Provider Demographics
NPI:1245437920
Name:CHABAN, ROSS (LPCC, LICDC)
Entity type:Individual
Prefix:MR
First Name:ROSS
Middle Name:
Last Name:CHABAN
Suffix:
Gender:
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 SYLVANIA AVE
Mailing Address - Street 2:SUITE 264
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3933
Mailing Address - Country:US
Mailing Address - Phone:419-517-4088
Mailing Address - Fax:419-517-4089
Practice Address - Street 1:6600 SYLVANIA AVE
Practice Address - Street 2:SUITE 264
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3933
Practice Address - Country:US
Practice Address - Phone:419-517-4088
Practice Address - Fax:419-517-4089
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-1728101Y00000X, 101YM0800X
OH923317101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2732412Medicaid